Cystic Neoplasms of the Pancreas

Abstract

Whereas pancreatic duct adenocarcinoma (PDA) is a well-studied (but still poorly understood) disease with a dismal prognosis, cystic neoplasms of the pancreas form a more recently recognized group of pancreatic tumors. They are diverse and variable in their pathologic characteristics, clinical course, and outcomes,1–3 although all portend a better overall prognosis than PDA. In recent years, with the improved sensitivity and increasing use of cross-sectional imaging in clinical practice, these lesions are more commonly identified,4 with many being discovered incidentally. Indeed, large radiological series using computed tomography (CT) or magnetic resonance imaging (MRI) have reported detection rates of pancreatic cystic lesions between 1.2% and almost 20%,5,6 approaching the 24.3% prevalence rate in an autopsy series by Kimura and colleagues.7 Although most of these lesions are pseudocysts, a significant portion consist of cystic neoplasms, which are estimated to represent 10% to 15% of all primary pancreatic cystic lesions.8 Given the growing clinical relevance of these tumors, a keen understanding of their natural history and pathophysiology is needed. This article reviews pancreatic cystic neoplasms, with a focus on the challenges encountered in their diagnosis and treatment.

Pancreatic pseudocyst: Dilemma of its recent management (Review)

“…Pseudocysts account for two-thirds of all pancreatic cyst lesions and are therefore more common than those caused by a pancreatic cyst neoplasm, which account for 10-15% of all pancreatic cyst lesions ( 4 ). The incidence of pseudocysts is 1.6-4.5 per 100,000 adults each year ( 2 , 15 ) and the prevalence ranges from 10-20% in acute pancreatitis and 20-40% in chronic pancreatitis ( 16 ).…”

“…The increase in the incidence rates of pancreatitis and the advancements made in radiological techniques have facilitated an increased number of diagnoses of pancreatic pseudocyst. Pancreatic pseudocyst is the most common type of pancreatic cyst lesion, with the incidence accounting for two thirds of all pancreatic cystic lesions, compared with pancreatic cystic neoplasm, which only accounts for 10-15% ( 4 ). Although pancreatic pseudocyst does not lead to malignancies as frequently as other types of pancreatic lesion, it is important to note that there is a group of tumors with malignant potential, including serous cystadenomas (SCAs), mucinous cystic neoplasms (MCNs) and intraductal papillary mucinous neoplasms (IPMNs) ( 5 ).…”

Post-Operative Complications Among Patients Treated with Cystogastrostomy for Pancreatic Pseudocyst

“…These pseudocysts commonly emerge as a consequence of chronic pancreatitis but can also originate from acute pancreatitis, pancreatic trauma, or post-pancreatic surgery events (2,3). With the increasing incidence of pancreatitis and advances in radiographic technologies, there has been an enhanced identification of pancreatic pseudocysts (4). They constitute the majority of pancreatic cystic lesions, accounting for about two-thirds, in contrast to pancreatic cystic neoplasms which only represent 10-15% (4).…”

“…With the increasing incidence of pancreatitis and advances in radiographic technologies, there has been an enhanced identification of pancreatic pseudocysts (4). They constitute the majority of pancreatic cystic lesions, accounting for about two-thirds, in contrast to pancreatic cystic neoplasms which only represent 10-15% (4). Despite their prevalence, pancreatic pseudocysts are less likely to become malignant compared to other pancreatic lesions; however, there is a critical need to recognize a subgroup of tumors with malignant potential, including serous cystadenomas, mucinous cystic neoplasms, and intraductal papillary mucinous neoplasms (6).…”